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Why Does she need so much more?

My LO is 5.5 months. I have been back to work for 2+ months now and I am having a hard time keeping up with my LO's demands when I'm not around. My sitters are family members and take excellent care for her. They are caring for her in our home. When I am not here she is eating what I pump in both sessions at work in one feeding! So in other words she has gone through my back supply and then some.

I'm afraid that when I return back to work after these 2 weeks home with her she is not going to have enough to eat while I'm not here.

I feed her all night long (or at least I think) we cosleep so she feeds and sleeps all through the night. I nurse her again once more before I leave for work, pump twice at work for 15 minutes each time, then nurse her when I get home. The two pump sessions at work give me about 5-9 ounces total in the morning then <4 ounces in the afternoon. LO is eating about 6-8 ounces in the morning and 5-6 ounces in the afternoon when I'm not home.

My care takers say that she is screaming for more after they give her the amount I pumped from one session, so they quickly thaw another bag and give her more-it's not until then is she satisfied.

I did try to start her on real food because I thought this would help "fill" her but she is not liking any of the foods I've been giving her. I don't want to give her formula. Please, please, please help!

Re: Why Does she need so much more?

Hi mama,

It's so hard when you are back at work and you are worried about your supply and what baby is getting. I'm sure you'll find lots of help here.

Can I ask you a few questions first?

What is your pump schedule? I know you said 2x/day but is that every 3 hours? every 4?
How long, in total, are you away from baby?
Do you know how they are feeding her with the bottle? Are they using paced bottle feeding?
When she screams, do they try any other ways of comforting her or is it straight on to another bottle?
Is she eating 6-8 ounces at one feed in the morning and 5-6 at one feed in the afternoon or is this spread over the whole morning?
What kind of pump are you using?
How do you determine how long you are pumping? Is 2 x 15 minutes all you are allowed?
When you pump, are you pumping through multiple let downs per side or only one?

I know that's a lot of questions, but I want to be sure we understand your situation better. It's possible (likely?) that with a few modifications to how LO is being fed and a few adjustments at the pump that you can fix this problem pretty easily.

Re: Why Does she need so much more?

Do you mean your baby is getting 6-8 ounces in one feeding in the morning and 5-6 ounces in one feeding in the afternoon? If so, that is an inordinately large amount for a breastfed baby to be eating in one sitting. I might start with asking them to break the bottles up into smaller bottles and feed more often, to mimic nursing. Assuming you're gone a full day (8-10 hours) that might not necessarily be too much milk total, but it is definitely too much at once.

How many hours are you at work? The general rule is that your baby needs 1-1.5 ounces per hour mom is away. Most breastfed babies take never take more than 4 maybe 5 ounces max (and that would be only occasionally).

Your pumping output looks pretty good actually, that is a really good amount to get out per pumping session. However 15 minutes is on the short side of duration. If you add in 5-10 minutes per session it might get you another few ounces each. Especially if you're not currently having more than one let down when you pump. Also or instead (again assuming a full work day) you might want to fit in a third session somewhere. On your lunch break, on your commute (it is possible to pump while driving), or at night right after baby goes to bed.

“We are not put on earth for ourselves, but are placed here for each other. If you are there always for others, then in time of need, someone will be there for you.”
--Anonymous

Re: Why Does she need so much more?

To answer evolvingmama's questions:

What is your pump schedule? I know you said 2x/day but is that every 3 hours? every 4? I pump roughly every three hours at work. Once at 9:15 and again at 12:20. I am a teacher so I am very limited as to when I can pump. Not easy getting this in because there is no finding coverage for my class while I pump daily. :-)
How long, in total, are you away from baby? I'm away from 7:30 - 3:30 (8 hours)
Do you know how they are feeding her with the bottle? Are they using paced bottle feeding? The only bottle she will take is one that I ordered online (mimijumi, I think thats how you spell it) it have the newborn or slowest flow nipple they have (they only have two).They feed her twice a day (same as I pump)between 9:30 and 10:00 and then again between 1 and 2.
When she screams, do they try any other ways of comforting her or is it straight on to another bottle? I don't believe they are. My husband says she doesn't scream for her but he's giving her 4 pump bags in one sitting to begin with. (I pump in the medela pump and save bags so 2 bags a session)
Is she eating 6-8 ounces at one feed in the morning and 5-6 at one feed in the afternoon or is this spread over the whole morning? My husband says she is eating 6-8 ounces every feeding with him. (Yikes! that's more than I can put out.)
What kind of pump are you using? I use the Medela Pump in Style
How do you determine how long you are pumping? Is 2 x 15 minutes all you are allowed? Like I said I am a teacher and only have small time slots to pump. See question 1
When you pump, are you pumping through multiple let downs per side or only one? I didn't know I could have multiple let downs. How do I know there are more than one occurring? I am usually doing work while I pump so I am not watching what is coming out.

So should I have them cut back and only give her what I pump at each session? When I am home with her she is nursed on demand. I don't really know how many feedings she has a day because if she wants it she gets it home or out. I have no issues with public breastfeeding so if I'm around she is hungry or needs comfort she gets it. She was an EBF baby up until 2 weeks ago when I tried giving her small amount of food- which she is not into, although multi grain cereal last night wasn't that bad. I just don't think she ready for it.

Re: Why Does she need so much more?

That's really helpful information. Still.here gave you some great information and links. As she said, the recommendation is 1-1.5 ounces per hour away, so in your case, you'd be looking at LO taking 8-12 ounces while you are away, which IS in the range you are producing. Here are some things to try:

Try leaving the milk in smaller bottles or freeze in smaller portions -- like maybe 3 ounces. It's okay if LO eats more times than you are pumping (so she could take 3-4 3 ounce bottles while you are gone, even though you only pump 2x). Definitely look at the link still.here gave you about bottle feeding a breastfed baby and share that with your carers -- I think a really key point is that babies can take a bottle very quickly, so it is VERY important for your carers to slow the feed down, taking short pauses every so often. Also, ask them to try other things to soothe her before giving her a second bottle straightaway--walking, singing, playing, etc. You know your baby best, so you can give them tips on what you do to soothe her when she is upset (other than nurse, of course).

For pumping, I agree that 15 minutes is on the short end of pumping. If you can lengthen this by even 5 minutes, I think that would help you. Or, as still.here noted try pumping in the car on your commute to add a session (use a hands free set up and get everything in place before starting the car. I haven't done this, but there are plenty of mamas on here who have who can give you a detailed "how to"). With regards to multiple let downs, yes you can pump through several. If you watch, you'll notice that your flow will slow and then seem to stop while you are pumping. If you continue to pump, you will stimulate another letdown (in my experience it is a slower and less voluminous let down, but more milk nonetheless). But, this would require you to pump a bit longer. Also try compressions while pumping to give you more output. The PIS is a double pump, right? You can also try to change the changeable parts on the pump, as those apparently wear out after about 3 or so months and can negatively impact output.

Why don't you try some of these and let us know how it's working? If you are still having trouble, we can try to think of some more suggestions.

Re: Why Does she need so much more?

I think having a sit-down chat with your care-givers is the best place to start. Be honest and let them know you love being able to leave your baby with family and that you need their help with continuing to provide your baby with breast milk. And then tell them specific ways they can help. Print out that link about bottle feeding and go over it with them.

“We are not put on earth for ourselves, but are placed here for each other. If you are there always for others, then in time of need, someone will be there for you.”
--Anonymous

Re: Why Does she need so much more?

Your child is being overfed. And that is essentially wasting your milk. You know it's wrong because the bottle feedings are supposed to mimic breastfeeding sessions. You just said you could never produce 6-8oz in a once sitting. WHICH IS RIGHT! So you child should never eat that much at one time. Just because a child WILL eat that much doesn't mean they NEED that much.

Re: Why Does she need so much more?

Thanks guys. I will talk with them and have them slow down on the feedings. I think I will have them do one bag at a time, with several pauses in the feeding, finish the bag and soothe other ways. If she's still hungry they can use the other bag from my pumping session, add in pauses and soothing following the feedings.
I hope this will work. I know my caregivers will be more than willing to work with me (it's my mom, MIL, and husband).
I will keep you guys posted. Again, I appreciate your input.